Abstract

Objectives Environmental contamination with DNA from Chlamydia trachomatis (CT) has previously been found in Genitourinary Medicine (GUM) clinics. There are no known cases of cross-contamination of
clinical samples and no known nosocomial infections. We investigated whether diagnostic samples could become contaminated
from the environment by running dummy sample and carrying out a patient-throughput analysis. A total of 29 748 patients attended
clinics over a year. Of these, 2860 (9.6%) had a positive Chlamydia test result.

Method (1) A run of dummy samples (60 urine samples and 10 swabs) were processed as normal clinic specimens. (2) Patient-throughput
analysis: Patient numbers attending the GUM clinic on a given day was categorised as low, moderate or high. χ2 Tests were used to look for associations between categorical variables and Chlamydia test positivity. A Poisson regression
model was fitted to look at the effect of the number of people in the clinic on the number of positive results in a given
day. As some clinics were only run on certain days of the week, a sensitivity analysis was later performed with attendances
at non-daily clinics removed.

Results All dummy samples tested negative and we did not find evidence of an association between daily Chlamydia positivity and clinic
attendance.

Conclusions It is unlikely that environmental or cross-contamination of CT has lead to significant numbers of false positive results.
Laboratories check for possible cross-contamination routinely. The extension of this simple routine practice to all clinical
areas could provide quality assurance, improving confidence in the results in clinics.